Análise Translacional Metabolômica Comparativa Do Fluido Intracanal Em Pacientes Vivendo Com O HIV/Aids Após Terapia Fotodinâmica

Resumo (EN)

Objective: To identify potential biomarker candidates in the intracanal fluid of people
living with HIV/AIDS (PLWHA) before and after conventional endodontic treatment,
with and without adjunctive antimicrobial photodynamic therapy (aPDT) using 0.01%
malachite green, evaluating changes related to disinfection and periradicular
inflammation and correlating them with systemic condition and the profile of
seronegative individuals. Methodology: This study was approved by the Research
Ethics Committee (CAAE: 80009024.7.0000.5512) and included 40 participants
distributed into four groups (n = 10): G1 – HIV-positive patients submitted to
conventional endodontic treatment with 2.5% sodium hypochlorite (NaOCl 2.5%); G2
– HIV-positive patients submitted to conventional endodontic treatment with NaOCl
2.5% associated with aPDT; G3 – seronegative individuals submitted to conventional
endodontic treatment with NaOCl 2.5%; and G4 – seronegative individuals submitted
to conventional endodontic treatment with NaOCl 2.5% associated with aPDT. All
participants presented pulpal necrosis and periapical lesion. Treatment was performed
in two sessions, with intracanal fluid collection before and after chemomechanical
preparation. Samples were processed at the Dempster Mass Lab (USP) and analyzed
by gas chromatography coupled with mass spectrometry (GC-MS) for identification
and quantification of metabolomic biomarkers. Results: Sociodemographic data
showed a sample (N = 40) predominantly composed of adults aged 30–49 years
(32.5%), with balanced racial and sex distribution. Metabolomic analysis demonstrated
a significant difference in global metabolomic structural area among groups at baseline
(p < 0.001), with higher values in G1 and lower in G3. After intervention, no differences
were observed among groups (p = 0.172), indicating structural homogenization. A total
of 1,100 metabolites were detected at baseline and 884 after intervention, with distinct
distribution of exclusive metabolites among groups (p < 0.001). The analysis of the 25
statistically significant metabolites included benzamide, glutamine, phenol, and indole
derivatives. Conclusion: The intervention promoted homogenization of the global
metabolomic structure, without differences associated with PLWHA status or aPDT.
The presence of exclusive metabolites indicated distinct functional profiles among the
evaluated conditions, and further studies are required to assess potential biomarker
candidates in this population.